International Journal o f Molecular Sciences
Kazimierczak, P.; Przekora, A.
It has been observed that bone fractures carry a risk of high mortality and morbidity. The
deployment of a proper bone healing method is essential to achieve the desired success. Over the
years, bone tissue engineering (BTE) has appeared to be a very promising approach aimed at restoring
bone defects. The main role of the BTE is to apply new, efficient, and functional bone regeneration
therapy via a combination of bone scaffolds with cells and/or healing promotive factors (e.g., growth
factors and bioactive agents). The modern approach involves also the production of living bone
grafts in vitro by long-term culture of cell-seeded biomaterials, often with the use of bioreactors.
This review presents the most recent findings concerning biomaterials, cells, and techniques used
for the production of living bone grafts under in vitro conditions. Particular attention has been
given to features of known bioreactor systems currently used in BTE: perfusion bioreactors, rotating
bioreactors, and spinner flask bioreactors. Although bioreactor systems are still characterized by
some limitations, they are excellent platforms to form bioengineered living bone grafts in vitro for
bone fracture regeneration. Moreover, the review article also describes the types of biomaterials
and sources of cells that can be used in BTE as well as the role of three-dimensional bioprinting and
pulsed electromagnetic fields in both bone healing and BTE.